Provider Demographics
NPI:1235872672
Name:MRI CENTERS OF TEXAS LLC MESQUITE SERIES
Entity Type:Organization
Organization Name:MRI CENTERS OF TEXAS LLC MESQUITE SERIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ULLOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-498-1963
Mailing Address - Street 1:PO BOX 224852
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-4852
Mailing Address - Country:US
Mailing Address - Phone:972-498-1963
Mailing Address - Fax:
Practice Address - Street 1:2712 I 30
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2710
Practice Address - Country:US
Practice Address - Phone:972-685-9820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty